Thursday
8:15 - 9:30 am
Why Compliance is Important for Physicians
Larry Goodman
Handout A
9:30 - 10:45 am
Investigations & Enforcment Issues Panel
Meredith Melmed, Kim Brandt, Sean McKenna, & Nicholas Messuri
(No handouts available)
11:00 am - 12:15 pm Breakout Sessions
101 Answers for Ten Common E&M Quandaries
Linda Spranger, Teresa Bivens (San Francisco) & Georgette Gustin (New York)
- Overview of the basics of E&M coding
- Discussion of ten case studies involving common difficulties in E&M coding and documentation
- Look forward—what’s ahead in E&M coding & documentation
Handout A
Handout B
102 The Language of Medicare & the Language of Physicians: Compliance Challenges in Making the Two Work Together (a case study using clinical trial billing)
Cynthia Boyd, Janis Anfossi & Ryan Meade
- Walk through a clinical trial billing case that will highlight the culture clashes that can occur when physicians meet compliance
- Learn how to deal with the conflict between the science of medicine and the language of Medicare
- Get tips on clinical care decisions that can cause billing compliance challenges for the compliance officer and the physician investigator
Handout A
103 Automating Your Billing Compliance Program
Brad Boyd, & Martha Weiner
- Improving productivity while maintaining staff levels
- Risk-based audit frequencies
- Tips for enhancing audit quality (case selection, consistent commenting, trend analysis)
Handout A
Handout B
2:30 - 3:45 pm Breakout Sessions
201 End of Life Decisions: The Current Legal Landscape and Implications for Physicians
Jacqueline Darrah
- Legal update on state and federal law affecting end of life decisions
- Balancing the physician’s legal and ethical obligations
- Practical considerations for physicians, patients and families
Handout A
202 The Nuts and Bolts of Health Care Fraud Investigations
Sean McKenna
- Presentation is geared toward both attorneys and compliance officers who represent health care providers
- Mechanics of health care fraud investigations from the government's perspective
- In the context of one or two hypotheticals: how the government obtains health care fraud cases; how the government goes about investigating the allegations and issues commonly encountered when settling/resolving cases
Handout A
203 Third-Party Billing for Physician Groups: What's Hot and What's Not
Karen Collier
- Working with third-party billing companies: percentage arrangements and government attitudes
- Relationships and responsibilities: what are you contracting for? To code or not to code, outsourcing issues
- Hot topics in compliance: false claims, HIPAA privacy & security, audits and appeals, refunds, reassignment, NPI
Handout A
4:00 - 5:30 pm Breakout Sessions
301 HIPAA Compliance: Been There, Done That, What's Next? Surprise, You Are Not Done
Marti Arvin
- The continuing requirements of HIPAA Privacy and Security compliance
- HIPAA auditing and monitoring techniques for the physician practice
- EHR: what does it mean to privacy and security?
Handout A
302 Resident Training
Debbie Troklus, Teresa Bivens (San Francisco) &
Georgette Gustin (New York)
- Provides insightful information on working with residents
- Discusses the resident documentation requirements
- Provides techniques for obtaining buy–in from residents
Handout A
303 Vendors and Inducements—How Physicians Can Protect Themselves
Bret Bissey
- Educational tactics to be utilized (to get the attention of resistant physicians)
- Policies/bylaws as a tool to minimize risk
- American Medical Association Ethical Opinions/Guidelines overview
Handout A
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